Should Patients Be Required to Receive COVID Vaccine to Be Listed for Kidney Transplant?: PRO

The question was posed whether patients with kidney disease or in kidney failure should be required to receive the coronavirus disease (COVID) vaccine before being listed for kidney transplant. Though requirements to be listed for kidney transplant are somewhat stringent, considering age, weight, the ability to match available donors, and how well a candidate would handle major surgery. In addition to other transplantation requirements, I do believe that this is one more requirement that could prove to be beneficial for those who are transplant-eligible and/or are waiting for a kidney transplant, as well as in transplant maintenance. This article is not necessarily to change your mind or personal views, but it should shed some light on the topic. First, let us briefly review some of the facts surrounding kidney disease and transplants.

According to the American Kidney Fund, there are at least 37 million people in the United States with kidney disease. 807,000 are living with kidney failure, of which over 500,000 are on dialysis and <250,000 have received a transplant.¹ Kidney disease affects as much as 15% of adults in America with minorities being at greater risk. Presently, there are over 90,000 people waiting for a kidney transplant, and with there being a shortage of donors, most patients with kidney failure are immediately placed on dialysis. In 2020, of 130,000 patients, <4000 were able to get a kidney transplant.² With this being the landscape for kidney disease patients, it is important to ensure that any potential transplant recipient is in the best position to not only receive their transplant but also to maintain it. Next, let us take a look at some of the COVID statistics.

The World Health Organization records over 760,000,000 COVID cases worldwide, of which nearly 7,000,000 ending in fatality.³ Whether those who contracted the virus had any preexisting conditions such as kidney disease, is not known. With the increasing number of various strands of the virus surfacing, it would be wise for those who have kidney disease along with other comorbidities to consider taking the vaccine, especially when the possibility of receiving a transplant is at stake. Another thing to consider is the after effects of contracting the COVID virus. Even the healthiest of individuals were left experiencing neurological symptoms, such as memory loss, depression, and anxiety. Some also experienced cardiac and respiratory symptoms. For transplant recipients, not only could they experience these symptoms, but there is also a possibility for organ failure or rejection.

Kidney recipients have so many things that they have to be cautious and aware of, in some cases, hypervigilant. You have to be responsible for your physical, mental, emotional, and even your sexual health. Things like watching restaurant scores, extreme heat, making sure you take all of your prescribed medications, and keeping your scheduled appointments. The main thing that is advised is to protect yourself from people. Especially sick people. With that being the case, taking the COVID vaccine should definitely be taken into consideration.

I have been a transplant patient for 3 years. I am also 2 years out from rejection, but I was still able to keep my transplanted kidney. I had both the initial vaccines and booster. As long as I had minimal to no contact with other people, I was just fine. Meaning that I was only going to my doctor's appointments, scheduled labs, and to the grocery store if absolutely necessary. However, when I decided that I would go back to work, within 2 weeks, I was diagnosed with COVID. Even with wearing mask in the office, handwashing, sanitizing, and doing my best to stay socially distant, it still did not stop me from catching it from others who did not take it as seriously. Since I had taken the vaccine, I had mild symptoms. I was immediately scheduled for an antiviral infusion that would help to prevent further progression or more severe symptoms of the virus. Had I not decided to take the vaccine as suggested, my symptoms could have been worse, and I may have potentially faced hospitalization and/or another organ rejection leading back to dialysis. Although each person's experience may be different, I personally agree with the COVID vaccine requirement for potential transplant patients. The kidney transplant is to help improve the quality of your life, having the COVID vaccine, ideally, is one of the preventative measures to help continue preserving the quality of your life.

In conclusion, the idea of having to take the COVID vaccine before being placed on the kidney transplant list may seem a little unnerving, and you may even say, “You didn't have to get the vaccine before you receive your transplant!” Yes, that is true, but it was very scary to receive my transplant when COVID was at its highest peak. The hospital was overrun with COVID cases. Aside from the issues I was having post-transplant, I was afraid there was a possibility I could get it while in the hospital. All in all, we really have to look at the big picture. We have to protect ourselves. Although we are strong in a sense, being immunocompromised makes us susceptible to many germs and viruses which could cause more severe health issues and even fatality. We have to be proactive in caring about our own health even when others do not. Let us do all we can to protect and preserve our quality of life.

Disclosures

The author has nothing to disclose.

Funding

None.

Author Contributions

Writing – original draft: LaMorgan Smith.